High ambient glucose augments angiotensin II-induced proinflammatory gene mRNA expression in human mesangial cells: effects of valsartan and simvastatin.

BACKGROUND: Hyperglycemia may potentiate the adverse renal effects of angiotensin II (AII). In the kidney, the major target of AII action is the glomerular mesangial cell, where its hemodynamic and proinflammatory action contributes to renal injury. AII action is mediated by several types of cell receptors. Among those, the AT1 receptor has been best studied using specific AII receptor blockers (ARBs). These agents have emerged as major new modalities in the prevention and amelioration of renal disease where the ARB renoprotective anti-inflammatory properties could be more important than previously appreciated. Like the ARBs, statins may also modulate inflammatory responses that are renoprotective and complement their cholesterol-lowering effects. AIM: The aim of this project was to (i) identify a repertoire of proinflammatory mesangial cell AII-inducible mRNAs; (ii) determine if the AII-induced proinflammatory mRNA responses depend on ambient glucose, and (iii) test the anti-inflammatory effectiveness of an ARB, valsartan, either alone or in combination with a statin, simvastatin. RESULTS/CONCLUSIONS: Using high-density microarrays and real-time PCR we identified several AII-inducible proinflammatory mesangial genes that exhibited augmented mRNA responses in high-glucose milieu. Valsartan blocked the AII-induced mRNA expression of proinflammatory genes (i.e. MCP-1, LIF and COX-2) maintained in normal and high glucose. These observations add to the mounting evidence that ARBs have anti-inflammatory effects in the kidney, a beneficial effect that may be more important in protecting renal function in diabetic patients. While simvastatin inhibited expression of some mRNAs encoding chemokines/cytokines, it enhanced expression of mRNA encoding COX-2, a key mediator of inflammation. Thus, the non-cholesterol effects of statins on inflammatory responses appear complex.

A randomized comparison of retention balloon and standard tip rectal catheters in preventing incontinence during double-contrast barium enema.

OBJECTIVE: The objective of this comparison was to determine if retention balloon catheters are more effective than standard tip catheters in preventing barium incontinence during double-contrast barium enemas. SUBJECTS AND METHODS: A prospective randomized study was conducted over a 1-year period after institutional review board approval. Two hundred twenty-three patients (102 men, 121 women; median age, 68 years; age range, 50-94 years) were randomized to retention balloon or standard tip catheter after giving informed consent. Barium incontinence was graded A (did not lead to examination failure) or B (led to examination failure). RESULTS: One hundred thirteen patients (51%) were examined with retention balloon catheters and 110 patients (49%) with standard tip catheters. In the retention balloon catheter group, 26 patients (23%) were incontinent (22 [19.5%] grade A, four [3.5%] grade B). In the standard tip catheter group, 31 patients (28%) were incontinent (24 [21.8%] grade A, seven [6.4%] grade B). No significant difference was seen in incontinence rates between the two catheter groups (p = 0.54, chi-square test). Sixteen patients (7.2%) gave a prior history of fecal incontinence. Of these, 15 (94%) developed incontinence, and in seven (44%), grade-B incontinence led to examination failure. CONCLUSION: Retention balloon catheters have no advantage over standard tip catheters at preventing barium incontinence. Given the possible higher rates of rectal trauma associated with retention balloon catheters, their use may not be justified. A prior history of fecal incontinence is a strong predictor of examination failure.

Interactions between important regulatory proteins and human alphaB crystallin.

Protein pin arrays assessed interactions between alphaB crystallin and 12 regulatory proteins, including EGF, FGF-2, IGF-1, NGF-beta, TGF-beta, VEGF, insulin, beta-catenin, caspase-3, caspase-8, Bcl-2, and Bcl-xL, which are important in cellular differentiation, proliferation, signaling, cytoskeletal assembly, and apoptosis. FGF-2, NGF-beta, VEGF, insulin, and beta-catenin had strong interactions with human alphaB crystallin peptides, and the alphaB crystallin interactive sequences for these proteins were identified. The seven remaining proteins (EGF, IGF-1, TGF-beta, caspase-3, caspase-8, BCl-2, and Bcl-xL) did not interact with alphaB crystallin. The alphaB crystallin sequences that interacted with FGF-2, NGF-beta, VEGF, insulin, and beta-catenin overlapped with sequences that selectively interact with partially unfolded proteins, suggesting a common function for alphaB crystallin in chaperone activity and the regulation of cell growth and differentiation. Chaperone assays conducted with full-length alphaB crystallin and synthetic alphaB crystallin peptides confirmed the ability of alphaB crystallin to protect against the aggregation of FGF-2 and VEGF, suggesting that alphaB crystallin protects these proteins against unfolding and aggregation under conditions of stress. This is the first report in which sequences involved in interactions with regulatory proteins, including FGF-2, NGF-beta, VEGF, insulin, and beta-catenin, were identified in a small heat shock protein.

N- and C-Terminal motifs in human alphaB crystallin play an important role in the recognition, selection, and solubilization of substrates.

The functions of the interactive sequences in human alphaB crystallin that are involved in chaperone activity and complex assembly of small heat shock proteins need to be characterized to understand the mechanisms of action on unfolding and misfolding proteins. Protein pin arrays identified the hydrophobic N-terminal sequence (41STSLSPFYLRPPSFLRAP58) and the polar C-terminal sequence (155PERTIPITREE165) as interactive domains in human alphaB crystallin, which were then deleted to evaluate their importance in complex assembly and chaperone activity. Size exclusion chromatography determined that the complexes formed by the deletion mutants, Delta41-58 and Delta155-165, were larger and more polydisperse than the wild-type (wt) alphaB crystallin complex. In chaperone assays, the Delta41-58 mutant was as effective as wt alphaB crystallin in protecting partially unfolded betaL crystallin and alcohol dehydrogenase (ADH) and significantly less effective than wt alphaB crystallin in protecting unfolded citrate synthase (CS) from aggregation. Chaperone activity did not correlate with complex size but corresponded with the amount of substrate protein unfolding. The results confirmed the importance of N-terminal residues 41-58 in selective interactions with completely unfolded substrates. Poor solubility and limited or no chaperone activity for the three substrates characterized the Delta155-165 deletion mutant, which demonstrated the importance of C-terminal residues 155-165 in maintaining the solubility of unfolded substrates in a manner independent of the amount of substrate protein unfolding. The results presented in this report established that interactive domains in the N- and C-termini of human alphaB crystallin are important for the recognition, selection, and solubility of unfolding substrate proteins.